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Wisconsin rates for HCPCS 00103

Anesthesia Eyelid Reconstructive Procedure

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
QX
Low / Median / High Price
$456.30 / $456.30 / $971.75
Aetna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$899.10 / $1,465.38 / $1,960.00
Aetna
Facility/Professional
Professional
Modifier
QZ
Low / Median / High Price
$306.55 / $306.55 / $1,729.75
Cigna
Facility/Professional
Professional
Modifier
AA
Low / Median / High Price
$698.15 / $698.15 / $793.35